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Avances en la comprensión de la leishmaniasis visceral: Desafíos, innovaciones y direcciones futuras en el manejo
1Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran, sums.ac.ir.
Background:
Visceral leishmaniasis (VL), also known as kala-azar, is a life-threatening neglected tropical disease primarily caused by Leishmania donovani and transmitted by infected sandflies. Despite notable advancements in public health, VL continues to pose significant challenges, especially in South Asia, East Africa, and South America.
Methods:
A systematic review was conducted in accordance with PRISMA guidelines. Peer-reviewed literature published from 2000 to 2024 was retrieved from PubMed, Scopus, and Web of Science to assess epidemiological patterns, diagnostic advancements, therapeutic options, and vector control strategies.
Results:
The analysis revealed progress in diagnostic tools such as rK39-based rapid tests and molecular diagnostics. Therapeutic improvements, notably liposomal amphotericin B and miltefosine, have emerged, although drug resistance and limited accessibility remain problematic. Vector control through residual spraying and community programs shows promise but is hindered by insecticide resistance. Furthermore, HIV co-infection and climate-driven spread exacerbate control efforts.
Conclusions:
Comprehensive management of VL requires integrative approaches that combine novel diagnostics, targeted treatment, innovative vector control, and robust public health systems. Emphasis on vaccine development, digital health solutions, and community participation is crucial for sustainable control and eventual elimination.
